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Q: In August 2008, my internist said studies had shown that statin drugs for diabetics promoted
heart health. At the time, my A1C (level of glycated hemoglobin) was 5.8; total cholesterol, 139;
and LDL, 75. He prescribed 5 milligrams of Crestor every other day.

By June 2009, my total cholesterol was 104; and LDL, 43. My internist wanted me to continue with
Crestor but lowered it to twice weekly because I was concerned that my LDL was too low.

I have a new internist, and my most recent report shows total cholesterol of 110 and LDL of 56.
My A1C is 5.7. She suggests that I consider stopping Crestor.

The internist who prescribed Crestor specialized in diabetes; the doctor I see now doesn’t.

I’m 65, and my Type 2 diabetes was diagnosed 10 years ago.

A: Statin drugs have been proved to reduce the risk of heart attack and death in many different
populations.

As a general rule, the higher the risk of heart disease, the greater the benefit of statins. Men
have a higher risk than women, and diabetics have a higher risk than non-diabetics. The higher the
total or LDL cholesterol, the higher the risk.

Low HDL cholesterol levels also increase the risk of heart disease. Of course, the older you
are, the higher the risk.

Your doctor needs to keep in mind all of these risks — as well as your family history, diet and
exercise habits, smoking history and blood pressure — to determine whether to recommend a statin to
you.

Some authorities recommend treating people with diabetes with a statin regardless of LDL
level.

I used an online calculator to estimate your risk of a heart attack in the next five years based
on your cholesterol without treatment, and it is about 5 percent. With treatment, your risk drops
to about 4 percent. The medication does reduce your risk a bit: 100 people like you would need to
be treated for five years to prevent one heart attack.

There was some concern about the dangers of too-low LDL in the 1980s, but more recent data
suggests that even very low LDL from statins doesn’t cause problems.

Q: I am in the market to purchase an infrared sauna for health purposes. My research indicates
that infrared waves benefit many situations — such as arthritis, Type 2 diabetes, detox, weight
loss, the relief of muscle pain, the killing of cancer cells and the lowering of cholesterol.

I have arthritis, and my boyfriend has diabetes.

Is this all true, and can it help me to become a healthier person? I would use the sauna daily
or three or four times a week.

A: An infrared sauna uses light waves to heat the body. People have been using traditional
saunas for centuries, and many swear by their benefits. Evidence suggests that saunas — infrared
ones, in particular — reduce pain and stiffness from some types of arthritis. I doubt that saunas
help with detox, weight loss or the killing of cancer cells.

I would caution your boyfriend with diabetes because some people with diabetes are less
sensitive to heat and could be burned without knowing.

Dr. Roach answers letters only in his North America Syndicate column but provides an order form
of available health newsletters. Write him at P.O. Box 536475, Orlando, FL 32853-6475; or
ToYourGoodHealth@med.cornell.edu.